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Although there has been no systematic evaluation of the efficacy of DESYREL (trazodone hydrochloride) beyond six is generally recommended that a course of antidepressant drug treatment should be continued for several months.

A major depressive episode may be the initial presentation of bipolar disorder. It is generally believed (though not established in controlled trials) that treating such an episode with an antidepressant alone may increase the likelihood of precipitation of a mixed/manic episode in patients at risk for bipolar disorder. Whether any of the symptoms described above represent such a conversion is unknown. However.prior to initiating treatment with an antidepressant.patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder. such screening should include a detailed psychiatric history.including a family history of suicide.bipolar disorder.and depression. It should be noted that DESYREL (trazodone hydrochloride) is not approved for use in treating bipolar depression.

Before having surgery.tell your doctor or dentist about all the products you use (including prescription drugs.nonprescription drugs.and herbal products).

Tell the doctor right away if you notice worsening depression/other psychiatric conditions.unusual behavior changes (including possible suicidal thoughts/attempts).or other mental/mood changes (including new/worsening anxiety.panic attacks.trouble sleeping.irritability.hostile/angry feelings.impulsive actions.severe restlessness.very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

Increased blood concentrations of digoxin (Lanoxin) and phenytoin (Dilantin) have been reported in persons taking trazodone due to a decrease in the metabolism (break-down and elimination) of these drugs by trazodone.

The FDA order desyrel font a black-box warning on trazodone.noting that taking the drug could increase the chance of becoming suicidal.

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